2026-03-31
Raffaele Natella, Michela Bruno, Maria Chiara Brunese, Gianfranco Vallone, Giulia Pacella, Laura Recchia, Luca Brunese, Marcello Zappia
Purpose: To evaluate the prevalence of adhesive capsulitis changes in MRI examinations after COVID-19 vaccine administration. Materials and methods: We performed a retrospective cohort study of 940 participants who underwent shoulder MRIs between 2018 and 2022 in a single institution. Two groups were identified: group 1, consisting of 470 reports (261 males, 209 females, mean age 55 years old) during the pre-vaccination period from 2018 to 2020, and group 2, including 470 reports (267 males, 203 females, mean age 53 years old) during the vaccination period from 2021 to the end of 2022. MRI images were reviewed by a single radiologist with 17 years’ experience in musculoskeletal radiology and evaluated for the presence of capsulitis. Results: Based on the reports from group 1 (2018–2020), the prevalence of positive reports of AC was 16.2% CI95% (13.0-19.9). There was a total of 76 cases, with 33 women and 43 men affected. Group 2 (2021–2022) observed that adhesive capsulitis had a prevalence rate of 23.4% CI95% (19.7–27.55); among the 110 reported cases, 50 were women and 60 were men. Analyzing the sample by focusing on the difference in prevalence by gender, group 1 has a prevalence of 56.6% (43/76) CI95% (44.7-67.6) of men and 43.42% (33/76) CI95% (32.3-55.3) of women, while group 2 has a prevalence of 54.6% (60/110) CI95% (44.8-64) in men and 45.5% (50/110) CI95% (36.0-55.2) in women. Considering the total number of capsulitis cases, a statistically significant difference is highlighted between the pre-vaccination and post-vaccination periods (Fisher’s exact test p=0.007).
2026-03-31
Karrar Hasan Albomahmood, Azadeh Shadmehr, Mohammad Hossein Ayati, Seyed Mohsen Mir, Sakineh Shab-Bidar
Objective: This systematic review of randomized controlled trials aimed to evaluate the efficacy of dry needling (DN) in improving pain and function among patients with myofascial trigger points in the upper trapezius muscle. Design: Systematic review conducted according to PRISMA guidelines, including randomized controlled trials. Methods: Studies were identified by searching PubMed, Scopus, The Cochrane Library, and Physiotherapy Evidence Database. Studies identified by electronic searches were screened against established, pre-defined inclusion criteria. These studies were randomized controlled trials that used DN for treating patients with active trigger points in the upper trapezius muscle with conventional treatments as controls. There are no specific limitations on the duration of treatment, the type of needling, or the severity of symptoms. These studies must have assessed pain sensitivity. Results: Four studies were included in this systematic review. The mean difference of pain sensitivity in all four studies for DN group was 0.59 kg/cm 2 , while in the control group was 0.05 kg/cm 2 , mean difference of pain intensity in DN group was 3.7 and control group was 0.7 and regarding to the range of motion (ROM) in DN group was 12.8 and control group was 6.3. Conclusions: This study showed significant positive outcomes in pain sensitivity, pain intensity, and range of motion following the intervention of DN, compared to the control group. Further high-quality randomized clinical trials with established protocols for applying DN are required.
2026-03-31
Eduardo Gasoto, Bruna Badotti Maciel, Heitor Pedro Berté Junior, Geicimara Lopes, Carlos Eduardo de Albuquerque, Gladson Ricardo Flor Bertolini
Purpose: To investigate the efficacy of photobiomodulation (PBM) on the iliotibial tract (ITT) in women with patellofemoral pain (PFP), analyzing pain, function, and ITT thickness. Methods: The study is characterized as a longitudinal randomized clinical trial, with analysis conducted in a clinical laboratory. The sample consisted of 30 women with PFP and 15 without knee dysfunction who were not engaged in regular physical activities. Volunteers with PFP were randomly assigned to a group that received PBM treatment and a group that did not. The variables analyzed included the Knee Pain Scale, the Knee Injury and Osteoarthritis Outcome Score, the Visual Analogue Pain Scale, the Pressure Algometer, and the measurement of ITT thickness on ultrasound images. PBM was performed at a wavelength of 660 nm and an energy density of 10 J/cm 2 on five points along the ITT over four weeks, totaling 12 sessions, with a total deposited energy of 0.9 J. The accepted significance level was set at 5%. Results: After treatment with PBM, there were no significant improvements in the group that received treatment (p >0.05). Conclusion: The use of PBM, in the parameters applied, on the ITT does not have an effective impact on the treatment of PFP.
2026-03-31
Anooj Pravin Chheda, E Dilip Kumar Naidu, Sabari Vaasan Lakshmi Kanthan, Nambiraj Gowthaman, Madhan Raju, Abraham Aleyas, Abhinand Madhulakshmi Jayachandran, Ashwin Mathew Kadavil
Introduction: Osteoarthritis (OA) is a common degenerative joint disorder marked by cartilage deterioration, subchondral bone alteration, and persistent synovitis. Effective nonsurgical interventions are crucial for alleviating pain and enhancing functionality. Methods: This prospective cohort study assessed 105 individuals aged over 45 years with mild to moderate knee osteoarthritis during a one-year duration. Patients were randomly assigned to three distinct categories: group 1 obtained intra-articular platelet-rich plasma (PRP) (n = 35), group 2 received intra-articular corticosteroid (triamcinolone acetonide, 40 mg) (n = 35), and group 3 received intra-articular hyaluronic acid (HA) (n = 35). Pain alleviation and functional enhancement were evaluated at baseline, 1, 3, 6, and 12 months utilising the Visual Analog Scale (VAS) and the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). Results: The baseline features were analogous across the groups. Group 3 (HA) consistently exhibited the most significant enhancement in both VAS and WOMAC scores at 3, 6, and 12 months (p < 0.001), while group 1 (PRP) and group 2 (corticosteroid) displayed comparable but lower enduring improvements. Conclusion: Intra-articular HA injections demonstrated superior efficacy compared to PRP and corticosteroid injections for sustained pain alleviation and functional enhancement in mild to severe knee osteoarthritis.
2026-03-31
Widya Khairunnisa Sarkowi, Stephen Ivano Chiuvan, Rifqi Kamil Amaanullah, Dafrina Kalyla Lofriman, Khalilah Ghina Salsabila, Pradiptha Aryasena, Auliya Akbar
Introduction: Rotator cuff tendon is vulnerable to acute and chronic injuries, leading to pain, reduced mobility, and decreased quality of life. Recovery is slow and frequently results in fibrotic changes, impairing full functional restoration. Currently, exosomes and extracellular-vesicles (EVs) have emerged as promising regenerative approaches for tendon. However, no clinical studies in humans have been reported for its use in rotator cuff injury. Therefore, this review aims to evaluate the efficacy and safety of exosomes/EVs in animal models of rotator cuff injury, as a foundation for clinical translation. Methods: A systematic search was conducted following PRISMA guidelines across PubMed, Scopus, Wiley, and EBSCOhost. Eligible studies included animal models of rotator cuff injury treated with exosomes/EVs. Data on exosomes/EVs characteristics, animal model, outcomes, and follow-up duration were extracted. Risk of bias was assessed using SYRCLE RoB tool. Results: Eleven studies were included in the review, involving 63 mice, 210 rats, 211 rabbits, and 12 sheep. Variations were noted in sources, concentration, and delivery methods for exosomes/EVs across studies. Exosomes/EVs demonstrated superior outcomes in tendon repair compared to controls, with improvements observed in macroscopic, histological, and biomechanical outcomes. Proposed mechanisms included enhanced extracellular matrix remodeling, reduced fatty infiltration, anti-inflammatory, and immune-modulation. Quality of included studies was generally moderate, with some studies exhibiting some risk of bias. Conclusion: Exosome and EVs might be effective for rotator cuff injury in animal models with minimum side effects. Further preclinical studies and clinical trials are necessary to validate efficacy and safety in humans.
2026-03-31
Ecaterina Vasenina, David H. Fukuda, Jack J. Livingston, Ashley A. Herda, Colby L. Mangum, Jeffrey R. Stout
Objectives: The objective of this study was to determine the test-retest reliability of gastrocnemius muscle thickness and stiffness measurements, maximal isometric force using seated and standing plantar flexion, and Achilles tendon length, thickness, and stiffness. Additionally, we aimed to assess the correlations between musculotendinous unit properties and unilateral isometric force assessments of the plantar flexor muscles. Methods: Twenty physically active males (23.79 ± 3.64 years, 175.56 ± 9.63 cm, and 83.41 ± 16.09 kg) completed the study. Participants underwent anthropometric assessments, ultrasound imaging for gastrocnemius muscle thickness and Achilles tendon properties, and myotonography for mechanical tissue characteristics. Unilateral standing and seated isometric plantar flexion tests were conducted using a force plate. Reliability was determined using intraclass correlation coefficients (ICC 3,k ) and coefficients of variation (CV). Stepwise regression assessed relationships between musculotendinous properties and isometric peak force. Results: Achilles tendon length, calf muscle thickness, and calf circumference exhibited excellent reliability (ICC >0.9), while Achilles tendon thickness (ICC = 0.89), calf echo intensity (ICC = 0.83), and seated isometric peak force (ICC = 0.93) demonstrated good reliability. Standing isometric peak force (ICC = 0.83) also showed good reliability, while calf stiffness (ICC = 0.96), calf frequency (ICC = 0.97), and Achilles tendon stiffness (ICC = 0.78) exhibited good to excellent reliability. Calf decrement correlated with standing peak force (R 2 = 0.23, p = 0.018), while Achilles decrement was associated with gastrocnemius muscle thickness (R 2 = 0.374, p = 0.004). Conclusion: Achilles tendon length, gastrocnemius muscle thickness, and stiffness are reliable for plantar flexor assessment. Relationships between muscle-tendon properties and force production highlight their structural influence. Standardized protocols are recommended for improved consistency.
2026-03-31
Claudia Luciano, Matteo Catananti, Giuseppe Rovere, Giulio Gorgolini, Alessandro Caterini, Fernando De Maio, Pasquale Farsetti, Vincenzo De Luna
Objective: A symptomatic accessory navicular bone can cause foot pain and, in some instances, a painful flatfoot with functional limitations. Treatment is generally conservative, but in selected patients, surgical management may be necessary. The purpose of this study was to analyze a series of selected papers to identify the best surgical treatment for symptomatic accessory navicular bone. Methods: A literature search was performed in MEDLINE database, Chocrane Library and Scopus database. The research was performed following the PRISMA guidelines. Articles published from 1998 to 2023 reporting clinical outcomes of pediatric patients affected by accessory navicular bone surgically treated were included. Results: From an initial pool of 76 studies, 8 were included in this review. These encompassed 228 patients (294 feet), with an average age at surgery of 12.4 years; 147 patients were female (64.5%) and 81 male (35.5%). The follow-up ranged from 10 months to 12 years. Most cases involved type II os tibiale externum (246 feet). Treatments varied: 57 simple excisions, 62 Kidner procedures, 22 excisions with suture anchor stabilization, 31 percutaneous drillings, 37 subtalar arthroereisis alone, 35 combined with Kidner procedure, and 50 with medial soft tissue reconstruction. Conclusions: While a definitive surgical treatment of choice for symptomatic accessory navicular cannot be indicated, simple excision without detachment of the tibialis posterior tendon appears to be a valid treatment option for resolving this syndrome. Associated procedures may be performed when a flexible flatfoot is present and symptoms persist.